[Infantile JRA and ACTH therapy].

Systemic juvenile rheumatoid arthritis is characterized by chronic arthritis and associated with extra-articular features. Although JRA may present at any age throughout childhood, the onset of symptoms during the first year of life is relatively uncommon. The diagnosis of infantile JRA is difficult because of poor complaints. We had a 7-month-old female, first onset at 6 months of age for daily "spiking" fever and skin rash, subsequently developed signs of systemic rheumatoid arthritis. Although aspirin or other nonsteroidal anti-inflammatory agents were used for the therapy, no significant effect was obtained. Prednisone was administered to control arthritis and serious systemic features, however no satisfactory effect was shown. In this patient a single morning alternate-day shot of ACTH-Z (4 units) was employed, and this regimen showed significant effect to control her clinical symptoms. It may be necessary to add a small dose of ACTH-Z for control in some cases of infantile JRA patient compared to adult cases.